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Maori Council calls on the DHB model to be abolished

Maori Council calls on the DHB model to be abolished – landmark survey finds District Health Board model fails to meet the needs of Maori – health outcomes at significant risk of declining

The New Zealand Maori Council will appear before the “Simpson Review” in Auckland today – the Health and Disability Services Review is looking at the DHB model and its relevancy

Key points:

79% of Maori do not trust the current District Health Model
82% of Maori feel they do not know what they are entitled to in terms of health care and follow up care when it comes to their local District Health Boards
83% of Maori are not comfortable accessing services through their local District Health Boards
82% of Maori did not feel their interaction with a local DHB or referral service met their needs

Key findings:

Our people have low trust in the current DHB model
Our people are confused about what they can access, when and through whom
Our people do not know (in the main) what they are entitled to
When confused they stop engaging and they stop responding (this could lead to late diagnosis)
Our people are more likely not to engage again once let down
Only then engage when the situation is critical
Are less likely to be able to afford private insurance (76% said they had never applied for health insurance)
Are less likely to be able to afford non-scheduled medicines
Are more likely to “trust and engage with their own – Iwi health providers”
The New Zealand Maori Council has conducted a landmark survey to find out what Maori think about the current District Health Board model – and if it is meeting or failing the needs of Maori. According to the Maori Council’s Executive Director, Matthew Tukaki, the findings are telling:

“Its not a shock to the system it’s more a case of the system failing our people in a significant way and it’s not just reflected in our data – all you need to do is look at how we are comparing across the board with non-Maori and the reality begins to hit home – that while there may have been some slight improvements in some areas in the main; the system has failed us.” Tukaki said

“Tairāwhiti Māori adults aged 25 years and over were 82% more likely than non-Māori to be hospitalised for circulatory system diseases (including heart disease and stroke) – in what world is 82% more likely to be acceptable? Māori were 46% more likely than non-Māori to be admitted with acute coronary syndrome, 50% more likely to have angiography, and just as likely to have an angioplasty or a coronary artery bypass and graft.” Tukaki said

“In Auckland Just under half of Māori infants were enrolled with a Primary Health Organisation by three months of age. On average, 432 hospitalisations per year of Māori children were potentially avoidable through preventive or treatment intervention in primary care (ambulatory care sensitive hospitalisations, or ASH), with the rate also 19% higher than for non-Māori children. Auckland Māori females were more likely than non-Māori females to be admitted with acute coronary syndrome, and to have revascularisation procedures. Māori male rates were similar to those of non-Māori males. However, Māori men generally had higher rates of admission than Māori women. Heart failure admission rates were 4 times as high for Māori as for non-Māori. Stroke admission rates were 45% higher for Māori than for non-Māori and hypertensive disease admissions twice as high.” Tukaki quoted from MoH data

“The DHB’s are essentially a law unto themselves with many of them broke and struggling. They are all inconsistent in their approach to Maori health and wellbeing and while the recent budget has gone a long way to address some of the debt they are carrying it doesn’t mean that we are doing enough to future proof the health care system – essentially do we need more than 20 District Health Boards with 20 cost centers, 20 expense lines and 20 governance structures? Is the system delivering better health outcomes for Maori? The answer is no.” Tukaki has said

“Then there is the contract out model – there is no suggestion at all that the DHB’s are actually working to support Iwi health and social services to build the capability and capacity to meet demand – instead it’s a race to the bottom on price not investing in the health of our people.” Tukaki said

“That’s why we join with many others to call time on the DHB model and look at new and innovative approaches for health care in New Zealand and from our perspective that means a system designed, developed and governed to provide Maori Health and Wellbeing services to our people. Specifically, we are wanting to see the following:

Integrated model of administration and coordination
Maori health funding authority
Maori health and mental health services provisioning
Maori workforce development and investment
Integration of Tikanga and culturally based approaches of care
Disability services model for Maori
Aged care services and support
Closer integration of broader Government services
Overhaul of the Ministry of Health


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